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Understanding these patterns is crucial to understand future outbreaks of SARS-CoV-2 or other respiratory pathogens in the country.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"abs2\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We tested 97,950 blood donation samples for IgG antibodies from March 2020 to March 2021 in 8 of Brazil\u2019s most populous cities. Residential postal codes were used to obtain representative samples. Weekly age- and sex-specific seroprevalence were estimated by correcting the crude seroprevalence by test sensitivity, specificity, and antibody waning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"abs3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The inferred attack rate of SARS-CoV-2 in December 2020, before the Gamma variant of concern (VOC) was dominant, ranged from 19.3% (95% credible interval [CrI] 17.5\u201321.2%) in Curitiba to 75.0% (95% CrI 70.8\u201380.3%) in Manaus. Seroprevalence was consistently smaller in women and donors older than 55 years. The age-specific infection fatality rate (IFR) differed between cities and consistently increased with age. The infection hospitalisation rate increased significantly during the Gamma-dominated second wave in Manaus, suggesting increased morbidity of the Gamma VOC compared to previous variants circulating in Manaus. The higher disease penetrance associated with the health system\u2019s collapse increased the overall IFR by a minimum factor of 2.91 (95% CrI 2.43\u20133.53).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"abs4\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>These results highlight the utility of blood donor serosurveillance to track epidemic maturity and demonstrate demographic and spatial heterogeneity in SARS-CoV-2 spread.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"abs5\">\n                    <jats:title>Funding:<\/jats:title>\n                    <jats:p>This work was supported by Ita\u00fa Unibanco \u2018Todos pela Saude\u2019 program; FAPESP (grants 18\/14389-0, 2019\/21585-0); Wellcome Trust and Royal Society Sir Henry Dale Fellowship 204311\/Z\/16\/Z; the Gates Foundation (INV- 034540 and INV-034652); REDS-IV-P (grant HHSN268201100007I); the UK Medical Research Council (MR\/S0195\/1, MR\/V038109\/1); CAPES; CNPq (304714\/2018-6); Funda\u00e7\u00e3o Faculdade de Medicina; Programa Inova Fiocruz-CE\/Funcap - Edital 01\/2020 Number: FIO-0167-00065.01.00\/20 SPU N\u00b006531047\/2020; JBS \u2013 Fazer o bem faz bem.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.7554\/elife.78233","type":"journal-article","created":{"date-parts":[[2022,9,20]],"date-time":"2022-09-20T06:15:26Z","timestamp":1663654526000},"update-policy":"https:\/\/doi.org\/10.7554\/elife.78233","source":"Crossref","is-referenced-by-count":14,"title":["SARS-CoV-2 antibody dynamics in blood donors and COVID-19 epidemiology in eight Brazilian state capitals: A serial cross-sectional study"],"prefix":"10.7554","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3907-423X","authenticated-orcid":true,"suffix":"Jr","given":"Carlos 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